Virginia health officials talk about limits on hospital liability
As the head of the Virginia Department of Health explained, the Virginia Department of Health faces significant challenges in holding hospitals accountable for patient health and safety.
Scripps News Morning Rush
When it comes to hospital safety, does bigger mean better?
A new rating of U.S. hospitals by the Leapfrog Group, a patient safety organization, suggests that hospitals that score well in limiting preventable errors tend to be part of larger health systems.
In its biannual Hospital Safety Grade Report for U.S. hospitals released Nov. 13, Leapfrog Group said 94% of hospitals that earned an “A” grade were in health systems with two or more hospitals. Leapfrog Group CEO Lee Binder said this may be a sign that high-performing health systems are implementing safety plans at all hospitals to limit errors, accidents, infections and other preventable harms.
Binder said the health system has expanded over the past decade through consolidation and acquisitions of smaller hospitals and medical practices. Although such consolidation has raised concerns about billing practices and physician independence, a silver lining may be that these large systems have the resources and attention to improve the quality of care.
“Some systems do a great job of safety,” Bender said. “They have a plan. They have a system-level strategy on how to drive better and safer outcomes for patients.”
What did the Leapfrog report do for the states?
Leapfrog ranks states based on the percentage of hospitals that earn an A on the organization’s report card. Utah had the highest percentage of top-ranked hospitals, with about 61% of hospitals earning an A rating. Virginia, New Jersey, Connecticut, and North Carolina round out the top five states with the highest percentage of A hospitals.
Four states had no A-grade hospitals: Iowa, North Dakota, Vermont, and Wyoming.
How did the hospital chain perform?
Hospital chains accounted for 90% of all hospitals assessed by Leapfrog and 94% of A grades.
HCA Healthcare, the nation’s largest hospital chain, earned A grades for 51 of its 163 hospitals, including 18 that earned the highest grade for at least two consecutive years.
More than a dozen small chains with two to seven hospitals earned A ratings across all rated hospitals, including Houston Methodist University, Loma Linda University, and Stanford School of Medicine.
Emphasis on safety
Leapfrog is one of several sources where patients can see the safety scores of their local hospitals. US News & World Report reports ratings and other information about hospitals and doctors. The Centers for Medicare and Medicaid Services provides a searchable database with detailed quality scores for hospitals. Other consumer sites like Healthgrades and Yelp collect feedback from patients.
Leapfrog reports letter grades for approximately 3,000 U.S. hospitals based on 22 measurements from Medicare and Medicaid, adverse event information, and Leapfrog’s hospital surveys. Leapfrog said its methodology was developed by patient safety experts at Johns Hopkins Armstrong Institute and reviewed by a national panel of experts. The organization reports information about all the hospitals it rates at www.hospitalsafetygrade.org.
Patient safety websites have proliferated since the Institute of Medicine’s seminal 1999 report, “To Err is Human,” found that medical errors cause up to 98,000 deaths a year.
In 2022, government surveillance investigators reported that one in four older Americans enrolled in Medicare experienced some kind of temporary or permanent harm while hospitalized.
Dr. Michael Ramsey, chief executive officer of the Patient Safety Movement Foundation, a nonprofit organization based in Irvine, Calif., said hospital safety overall has improved in recent years due to increased focus on patient safety.
Medicare will reduce payments to hospitals that are not doing enough to prevent hospital-acquired infections and patients who are readmitted within 30 days with the same symptoms.
Ramsey said Medicare’s proposal to analyze hospital data within weeks after a patient is discharged from the hospital for surgery or other procedures would facilitate timely improvements. Hospitals and doctors will no longer be able to claim that regulators are using outdated data.
“When you get real numbers in real time, people change,” Ramsey said. “It’s going to change dramatically because it’s unavoidable.”
Why some F-grade hospitals are pushing back
A total of 18 hospitals that are part of the chain earned an F grade, including five hospitals owned by Tenet Healthcare. These hospitals included three hospitals in the Detroit area, St. Francis Hospital in Memphis, Tennessee, and Delray Medical Center in Delray Beach, Florida.
Delray Medical Center is one of five Tenet-owned Florida hospitals that filed a lawsuit in federal court in April, alleging that Leapfrog’s hospital performance is a “brazen compensation system” that “distorts the truth, misleads patients, and seriously harms hospitals.” Other plaintiffs include Good Samaritan Medical Center, Palm Beach Gardens Community Hospital, St. Mary’s Medical Center, and West Boca Medical Center.
Leapfrog denied the hospital’s claims in a lawsuit filed in September, saying the suit was an attempt to silence “Leapfrog’s right to free speech regarding public issues.”
A Florida hospital asked a U.S. District Court judge in the Southern District of Florida to rule in its favor and order Leapfrog to remove the hospital’s rating from its website and other materials.
In a statement, the hospital told USA TODAY that Leapfrog’s “dangerous and misleading safety ratings are causing tremendous and immeasurable harm to local hospitals, patients, and the public.”
Binder denied claims by Florida hospitals that they needed to participate in Leapfrog’s study to get good results.
“Leapfrog does not operate on a play-for-play basis,” Binder said. “The Leapfrog Hospital Survey is free for hospitals to complete, and all Leapfrog assessments and data are free and accessible to the public.”
